Tiltable table for radiofluoroscopic apparatus



April 23, 1968 sumo mo ET AL 3,379,877

TILTABLE TABLE FOR RADIO-FLUOROSCOPIC APPARATUS Filed April 2, 1965 3 Sheets-Sheet l m 4 w W N l E K W m m M U 8 0 M ri- M W f MW M W v m April 23, 1968 umo MAKING ET AL 3,379,877

TILTABLE TABLE FOR RADIO FLUOROSCOPIC APPARATUS Filed April 2, 1965 5 Sheets-Sheet 2 53 52 66 5 6 57 24 I I I l4-7 5; e 4 Q; m 75 73 7 60 GI 67 68 i I I I 5 6O 76 a 5 L 4 F 1 7 17) 2 53 56 5? 23 72 6 I F I 3 71 52 53 INVENTOR F I G, 5 I SUM/0 MAKINO MAsm os/ [M70 April 23, 1968 su vuo MAKINQ ET AL 3,379,877

TILTABLE TABLE FOR RADIO-FLUOROSCOPIC APPARATUS 3 Sheets-Sheet 5 Filed April 2, 1965 F i G. 6

SUM/0 MAMA/O m MAsm os/ Evao 1N VEN TOR-S My; *6

United States Patent 3,379,377 TILTABLE TABLE FOR RADHO- FLUQROSCQPEC APPARATUS Snmio Malriuo, Yokohama-shit, and Masayosi Endo, Kawasaki-ski, Japan, assignors to Tokyo Shihaura Electric o., Ltd, Kawasaki-shi, Japan, a corporation of Japan Filed Apr. 2, 1965, Ser. No. 444,951 Claims priority, application Japan, Apr. 24, 1964, 39/231,222 4 Claims. ((1. 259-57) ABSTRACT OF THE DESCLGSURE A table, adapted to support a patient, is supported by a casing located under said table. The casing, and with it the table, are tilted by a first driving motor around one end, in a direction to elevate the other; and a second driving motor tilts the table only and with respect to the casing, around the other end of said table and about an axis adjacent to the opposite end of said casing.

This invention relates to a radio-fluoroscopic apparatus and more particularly to a novel radio fluoroscopic apparatus wherein tilting and vertical movements of a table can be effected smoothly.

In radiation therapeutic apparatus utilizing radioactive rays such as X-rays, electron rays and the like it is necessary to accurately determine the location, size and shape of diseased tissue or organ of a patient. To meet this requirement, radiation therapeutic apparatus has been proposed wherein the body of a patient who was given a contrast medium utilizing radiations, such as a solution of barium, is inclined to various angles to determine the location, size and shape where of the disease occurs by observing the movement of the contrast medium in the body of the patient. in such a radiation therapeutic apparatus it is usual to lay the patient on a tiltable table which is disposed at a suitable height (about 80 centimeters, for example) above the floor and to determine the location of the diseased tissue by means of a source of radiations and a radiation detector associated with the table.

The conventional tilting apparatus for the table can be conveniently classified into the so-called two leg one point support type and one leg one point support type wherein a single supporting device is provided at substantially the mid-point of the table for tilting the table.

In such a tilting apparatus, however, the maximum angle of inclination of the table is limited to only about owing to the size of the table and the height thereof above the floor. As a result it is often difficult to exactly and correctly determine the location, size and shape of the diseased tissue of the patient. As improved tilting apparatus of these one point support type there have been devised tilting apparatus of the two leg two point support type and one leg two point support type. In these improved tilting apparatus, each one supporting device is provided at the fore and aft ends of the table and the table is constructed to rotate or swing around one of these supporting devices when it is desired to tilt the table. With this type of tilting apparatus, although the table can be tilted within a range of about i180, undesirable impacts are created between the table and its supporting device when the supporting point of the table is transferred from one point to the other, or from fore point to the aft or vice versa. This will give large shocks to patients and often render diagnosis of serious cases impossible.

As a further improvement of these prior arrangements,

3,37%,877 Patented Apr. 23, 1968 there was proposed a supporting apparatus wherein a table is mounted upon a ring carriage so that it can be tilted up to 360 without using any supporting point. This construction, however, requires a large ring carriage sufiicient to support the table. Consequently the physical dimensions of the therapeutic apparatus become excessive. Moreover access for operators to patient is difiicult because the ring carriage is positioned to completely encircle the table, at least on one side thereof.

It is therefore an object of this invention to provide an improved radio-fluoroscopic apparatus wherein the table thereof can be tilted over a wide range of angles without any undesirable shock.

A further object of this invention is to provide a novel radio-fluoroscopic apparatus wherein the height and angle of inclination of the table can be readily and smoothly varied.

A still further object of this invention is to provide a novel tilting apparatus for the table of a radio-fluoroscopic apparatus by which the table can be tilted in opposite directions over a wide range.

Briefly stated, a preferred embodiment of this invention comprises a table adapted to support a patient, a source of radiations, and a detector responsive to said radiations after passing through the body or diseased portion of the patient, said detector and said source of radiations being adjustably mounted on said table in the longitudinal direction thereof a casing is located beneath the table. A first driving mean is provided to tilt said casing around a first axis located adjacent to one end of the casing. A second driving means secures the table to the casing and provides for tilting the table around a second axis located at the end of the table which is adjacent to the opposite end of said casing.

More particularly, the casing encloses first and second driving motors, means to pivotally support said casing on a fixed axis transverse to said casing and located on the bottom thereof adjacent to one end of said table, a fixed arcuate sector gear, a gear driven by said first motor and arranged to cooperate with said arcuate sector gear to rotate said table around said transverse axis, a second arcuate sector gear mounted on said table near the opposite end thereof and a second gear driven by said second driving motor and arranged to cooperate with said second arcuate sector gear to rotate said table around the axis of said second gear. Further a coupling means is provided between said casing of the tilting apparatus and said table to always interconnect them. By this improved tilting apparatus the table can be tilted around said transverse axis or around said axis of said second gear in the clockwise or counterclockwise direction to change the angle of inclination of said table over a wide range without any shock to the patient by the selective energization of said motors.

These and other objects and advantages of the invention will be better understood from the following description when taken in conjunction with the accompanying drawings, in which:

FIG. 1 shows a side elevation of a radio-fluoroscopic apparatus constructed in accordance with this invention in which solid lines indicate the horizontal position of a table and phantom lines the vertical position thereof;

FIG. 2 is a transverse sectional view of the apparatus shown in PEG. 1 taken along a line II-II, when it is in the horizontal position;

FIG. 3 is a sectional view taken along a line III-IlI of PEG. 2;

FIG. 4 is an enlarged sectional view of a coupling device between the table and a tilting apparatus;

FIG. 5 is a side view of the radio-fluoroscopic apparatus when its table is tilted in the reverse direction; and

FIG. 6 is a side view similar to FIG. 1 to explain the manner of varying the height of the table while it is maintained in the horizontal direction.

Referring now to the accompanying drawings which illustrate one preferred embodiment of this invention, a radio-fluoroscopic apparatus, generally designated by a reference numeral 10 in FIGS. 1 and 2 comprises a table 11 upon which a patient is to be laid to take a radiofiuoroscope or for medical treatment purposes, and a tilting apparatus to tilt this table, which is generally designated by a numeral 12.

The table 11 is shaped like a boat. It has a supporting frame 14 and an upper plate 13 supported thereby and is adapted to directly support a patient thereon, said upper plate being made of a laminated board, a press board, an aluminum plate and the like which are transparent to radiations. Within the supporting frame 14- is disposed a suitable source of radiations 15 such as an X-ray tube, a betatron, C0 and the like, and a suitable detecting apparatus 16, such as an X-ray fluorescent plate, photographic film and the like is mounted above the table to oppose said source of radiations 15. As best shown in FIG. 2, the supporting frame 14 comprises a pair of side frames 17 and 13 made of aluminum or iron tubing, the upper plate 13 and plates 19 of aluminum which are secured to the upper, fore and aft and side surfaces of the frame work. It is preferable to construct the table to have light weight as far as possible to effect its easy manipulation. The tilting device 12 for the table comprises a pair of arcuate gears 21 and 22 having teeth 26 on their outer surfaces and respectively secured to the opposing inner walls of the side frames 17 and 18 at the right hand end of the table, as viewed in FIG, 1 and driving gears 23 and 24 meshing with the arcuate gears 21 and 22, respectively.

A pair of opposing longitudinal guide channel members 25 and 26 adapted to slidably support the radiation source 15 are secured on the upper portion of the inner walls of the side frames 17 and 13, as shown in FIG. 2. Similarly, a pair of longitudinal guide channel members 27 and 28 are secured on the upper and lower portion of the inner wall of the side frame 17 to slidably receive a balancing weight 29 for the purpose to be described later. As schematically illustrated, the radiation source 15 including a suitable window 30, diaphragm device 31 and the like is mounted on a supporting arm 38 which is slidably mounted on a supporting frame 32. This supporting frame is provided with a pair of upright arms 33 and 34 which serve to journal guide rolls 35 and 36 rolling along said guide channel members 25 and 26, respectively. A duct 37 is connected to the radiation source 15 through which extends a high potential cable when the source comprises an X-ray tube or betatron or a control flexible cable when the source comprises cobalt 60. In some case cobalt 60 is located separate from the table in which case the duct 37 is used to transmit radiations from cobalt 60 to the window 30.

An arm 33 extending through the side frame 18 of the table 11 is connected to the supporting frame 32.. The detector 16 is supported by the outer end. of the arm 38 through arms 39 and 40. The frame 46 is so positioned as to cause said detector 16 and radiation source 15 to oppose each other and is provided with shielding plates 42 and 43, generally termed as protective aprons to guard the operator against radiations. As will be described more in detail as the description proceeds an operating handle 44- is provided for the frame 4-0 to move the radiation source 15 and the detector 16 along the guide channels 25 and 26, and a stop plate 45 is provided at one end of the table to support the patient when the table is tilted.

Regarding now to the tilting apparatus 12, this apparatus is mounted upon a rigid foundation 519 through a table plate 51 extending between side frames 17 and 13. The table 11 is supported on the table plate 51 by means of a pair of spaced pedestals 53 which are connected to the bottom of the table by means of pivot pins 52 at or near the lower left hand end of the table as viewed in FIG. 1,

The driving means of the tilting apparatus 12 also com prises a pair of driving motors 54 and 55 positioned beneath the central portion of the table 11 and driving gears 23, 24 and 56 respectively driven by said motors. The gears '56 mesh with stationary arcuate sector gears 57 having their centers of curvatures at the axes of said pivot pins 52, and the gears 23 and 24 mesh with the teeth 26 of the arcuate gears 21 and 22 as described hereinbefore.

As shown in FIG. 3 the driving motors 54 and 55 are enclosed in a rigid casing 60 made of steel plates, for example, and are arranged to drive gears 23, 24 and 56, respectively, through couplers 61 and 62, reduction gears 63 and 64, internal gears 65, 66, 69 and 70 and driving shafts 67 and 68.

When driven by the motor 54, the gears 56 will rotate along the sector gears 57 to tilt the tilting apparatus 12 around the axes of the pivots 52 which are transverse to the table while the gears 23 and 24 rotate along the sector gears 21 and 22 to tilt the table 11 around the axes of the gears 23 and 24.

FIG. 4 shows the detail of a coupling device between the tilting apparatus 12 and the table 11, wherein a reference numeral 60 represents a portion of the casing which encloses the driving means of the tilting apparatus and said driving shaft d8 is shown to extend through it. At the outer end of this shaft is secured the gear 23 by means of a pin 71. This gear 23 meshes with the teeth 20 of the sector gear 21 which is secured on the outside of a reinforcing plate 72. by means of a screw 76, said plate 72 being welded to the side frame 17 of the table. A stud 74 of a guide roll 73 is secured to the casing 70 to guide the roll along an arcuate channel 75 having the same center of curvature as the sector gear 21. It should be understood that an identical coupling device is also provided between the driving gear 24 and the arcuate gear 22.

The operation of the illustrated apparatus is as follows:

A patient (not shown), assumed to have a disease in his stomach, is laid on and fixed to the horizontal top plate 13 of the table 11 with his feet in contact with the stop plate 55 and with his head directed towards the left, as viewed in FIG. 1. Ordinarily his breast is directed towards the doctor 16, and then the patient is given a contrast agent such as a solution of barium.

After completing such prelimnary operations tilting operation of the table and radio-fluoroscopic photographing will then be performed. When the table is positioned horizontally as shown by solid lines in FIG. 1 the contrast agent will be collected on the inner wall of the patients stomach on the side towards his back. Then the patient, particularly his stomach, will be irradiated by radiations from the radiation source 15 through the diaphragm device 31 and the window 30 and the shadow of the stomach will be produced on a fluorescence screen or a photographic film contained in the detector 16.

To examine the upper portion of the patients stomach the table 11 will be turned or tilted in the counterclockwise direction to the position indicated in FIG. 5. Thus, the motor 54 is energized to rotate the driving gears 56 in the clockwise direction to move them upwardly along sector gears 57 whereby to tilt the table by an angle of about 30 in the counterclockwise direction to the position indicated in FIG. 5. During this tilting movement the relative position between the driving gears 23, 24 and the sector gears 21 remains unchanged. Such a state of inclination wherein the head of the patient is held below his feet is commonly termed as reverse inclination. During the course to reach this reverse inclination a number of photographs are taken to examine various portions of the stomach. To further increase the angle of the reverse inclination the motor 55 is energized to tilt the table around the axes of the gears 23 and 24 by the cooperating action of these gears and sector gears 21.

To examine the lower portion of the stomach the electric motor 55 is energized to rotate the table from the horizontal position to the vertical position shown in FIG. 1. In this case, the casing 60 is maintained stationary in its horizontal position and the gears 23 and 24 are driven in the clockwise direction so that the roller 73 will be rotated in the arcuate channel 74 integral with the; sector gear 21'. Again, a number of photographs of various portions and positions of the patients stomach can be taken during this tilting movement.

By operations described hereinabove, about 75% of the patients stomach excepting its front portion can be examined by the radio-fluoroscopic apparatus. Thereafter the patient is laid horizontally on the table upside down to take fluoroscopic photographs. In this way, it is possi ble to examine the entire inner surface of the patients stomach wherebyjto determine the exact location and state of diseased portion thereof, thus providing accurate data to remedy it.

In practical use of the radio-fluoroscopic apparatus, it is necessary to make minor changes in the position of the radiation source and of the detector 16 dependent upon the height of the patient, the position of his stomach and the like. To this end the operator manipulates the handle 44, FIG. 1, to move longitudinally the radiation source 15 along channels 25 and 26 through arms 40, 39 and 38 and supporting arms 33 and 24. In this case, the total weight of the detector 16, the arm 38, the radiation source I15, etc. causes the balancing weight 29 located on the left hand side of the table (FIG. 2) to always cooperate therewith along guide channels 27 and 28. The detail of the mechanism for adjusting the balancing weight 29 is not shown in the drawing because it is immaterial to the present invention.

It is also to be understood that other portions of the body of a patient, such as blood vessels, a trachea, intestines, a spinal cord, a spinal column, bones and the like can be examined in the same manner as above described by the novel radio-fluoroscopic apparatus.

Thus the table of the radio-fluoroscopic apparatus can be tilted to various positions over a wide angle including reversely tilted position, shown in FIG. 5 and vertical position, shown in FIG. 1. Moreover as the table and the tilting apparatus therefor are always coupled together, the table can be tilted by any desired angle without imparting any undesirable shock to the patient.

Moreover, as above point out, it is able to reversely tilt the table by more than 30. Referring to FIG. 5, the motor 55 is so driven that the table 11 is reversely tilted by means of the tilting apparatus 12. Upon this driving operation, the motor 54 may be driven so as to tilt the table to the direction of the reverse inclination. This may be achieved by rotating the driving gears 56 in the clockwise direction and setting the length of the sector gears 57 meshing therewith to be long. While it is obvious that the angle of the reverse inclination is affected by the configuration of the table 11 or of the radiation source 15 or the like, it is able to reversely tilt the table by 75 or even substantially 90.

In performing radiation therapies it is often desirable to elevate the horizontal position of the table to more than that shown in FIG. 1. This state can be readily and simply provided by firstly bringing the table to the reversely tilted position shown in FIG. 5 and then turning the table in the clockwise direction around the gears 23 and 24 to the horizontal position indicated by the phantom lines in FIG. 6 by energizing the driving motor 55.

Thus, by the novel radio-fluoroscopic apparatus constructed in accordance with this invention, the table utilized in radiation therapy may be tilted over a wide range covering or even to +90 or more. Moreover, during the tilting operation the table is positively coupled to the tilting apparatus so that it is moved smoothly without imparting any undesirable shock to the patient. Further the horizontal height of the table can be varied to any suitable height convenient to operators.

While the embodiment of the invention as herein disclosed constitutes a preferred form thereof, it is to be understood that other forms might be adopted without departing from the true spirit and scope of the invention as defined in the appended claims.

What is claimed is:

1. A radio-fluoroscopic apparatus comprising a table adapted to support a patient and the like, a source of radiation, a detector responsive to said radiation after passing through the body of said patient, said source of radiation and said detector being mounted on said table, a casing located under the table, and means to tilt said table, said means including a first driving means to tilt said casing around a first axis located adjacent to one end of said casing and a second driving means to mount said table on said casing and tilt said table with respect to said casing around a second axis located at the end of the table which is adjacent to the opposite end of said casing.

2. The radio-fluoroscopic apparatus according to claim 1 wherein said means to tilt said table comprises first and second driving motors, and means supporting said casing on a fixed axis transverse to said casing and located adjacent to one end of said table, a fixed arcuate sector gear, a gear driven by said first motor and arranged to cooperate with said arcuate sector gear to rotate said table around said transverse a.;is, a second arcuate sector gear mounted on the table near the opposite end thereof and a second gear driven by said second driving motor and arranged to cooperate with said second arcuate sector gear to rotate said table with respect to the casing around the axis of said second gear.

3. The radio-fluoroscopic apparatus according to claim 2 wherein said second arcuate sector gear mounted on said table is provided with an arcuate guide channel concentric with the teeth of said second arcuate sector gear and a roller is secured to said casing to move along said guide channel.

4. The radio-fluoroscopic apparatus according to claim 1 wherein said table is provided with a pair of spaced longitudinal guide channels and means is provided to adjust the longitudinal position of said source of radiations and said detector along said guide channels.

References Cited UNITED STATES PATENTS 1,874,582 8/1932 Nelson 25055 1,957,720 5/1934 Nelson 25057 2,835,824 5/1958 Schepker 25058 3,131,301 4/1964 Barrett et al. 25055 RALPH G. NILSON, Primary Examiner. A. L. BIRCH, Assistant Examiner. 

